TKR Fall during exercise session

[Pumpkin]

@FraidyCat ,
Sorry to hear your trainer over worked you.
You may want to ask for a different trainer, hopefully someone with interest and experience working with seniors.

Your knee and hip muscles will become stronger as you increase your normal activity, combined with an exercise program that works for you. You do not need to do excessive work to get stronger.

If you feel a trainer or PT is pushing you too hard, remind them that you have had two falls that set your recovery back, and you do not want another incident.
Let them know you are not going tolerate anyone pushing to too hard.

Some days it is wiser to do 5 reps and 1 or 2 sets, there are just days when your body says take it easy today.

One of our former moderators used to say: "No matter how slow you go, you are lapping people sitting on a couch".

 

[FraidyCat]

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Thanks for your reply, @Jockette. I apologize but I'm not clear on the difference between "Your threads" and "Threads with your posts." If you could clarify, I'd appreciate it. Also, how do I "bookmark a thread"? By "Save to pocket"?

I'm definitely going to raise the topic of strengthening exercises with both my (new) PT and the very experienced PT with whom I work at the gym. Today when I fell I was working with a much younger, less experienced PT, though prior to today I'd had no reason to doubt his expertise. I'm puzzled as to why he didn't anticipate that I could fall and therefore wasn't in a position to catch me.

I think/hope you're probably right about the pain being confined to the soft tissue. But if it feels much worse tomorrow I will call the surgeon's office, as you suggest.

 

[FraidyCat]

If you feel a trainer or PT is pushing you too hard, remind them that you have had two falls that set your recovery back, and you do not want another incident.
Let them know you are not going tolerate anyone pushing to too hard.

Some days it is wiser to do 5 reps and 1 or 2 sets, there are just days when your body says take it easy today.

@Pumpkin Thanks for your response. I've felt like several of the PTs (I've had quite a few over the last 6.5 months) and both trainers have pushed too hard, but when they tell me I "won't get better" unless I do this, that, or the other, I'm inclined to go along with whatever they're instructing me to do. But I suspect if i'd been doing 2 sets vs. 3 and 5 reps vs. 8 today, this fall wouldn't have happened.

 

[Jamie]

He didn't anticipate the possibility of you falling because he's a trainer and not a therapist. He's not used to working with people in recovery.....his training is for people to become stronger to participate in sports or other physical activity. Granted, you may find good trainers that study and learn over and above what a trainer's job is. I have one like that whom I love dearly. But it's just not the norm and you must be more careful if it's someone you don't know well.

 

[FraidyCat]

Oh no, @FraidyCat! That must have been very frightening. I agree with Jockette that it's likely soft tissue and will improve with some rest, icing and elevation.

I'm at a loss as to how to set limits with my trainers and PTs so that on the one hand I'm not exerting myself with zero benefit while on the other protecting myself from injury.

This is a challenge for so many of us. But, I urge you to have a heart-to-heart talk with your trainer(s) since you are not someone who was prone to falling before and this is your second fall doing the same exercise, it seems as though your trainer(s) are pushing you to do too much too soon.

Also, keep in mind that a personal trainer does NOT have the same education in physiology and body mechanics as a physical therapist. And they certainly are not trained in how to rehab someone after a joint replacement.

If it was me, I'd schedule an appointment with a physiatrist or physiotherapist to get a formal assessment and figure out why you've fallen twice. A qualified expert can provide guidance on what you should -- and should not -- be doing that you can take back to your trainer. to help them make adjustments to your program.

@benne68 Thank you for your input. Though several of my PTs over the last 6.5 months have communicated with my more experienced personal trainer (who isn't the one I was working with today), I'm afraid they've all been overestimating both the pace and the level of effort of which I'm currently capable without risking injury. I'm not familiar with the field of physiatry but will certainly look into it.

 

[Jamie]

Just ignore anyone who tells you that you won't get better without pushing yourself hard. Some challenge is good but you are not in training, you're in recovery and it's counter productive to push yourself to the point of pain or exhaustion. Don't be afraid to say "enough" and stop for the day.

 

[FraidyCat]

He didn't anticipate the possibility of you falling because he's a trainer and not a therapist. He's not used to working with people in recovery.....his training is for people to become stronger to participate in sports or other physical activity. Granted, you may find good trainers that study and learn over and above what a trainer's job is. I have one like that whom I love dearly. But it's just not the norm and you must be more careful if it's someone you don't know well.

@Jamie You make an excellent point. He is very young--only about 26--and he only works as a trainer on the weekends--he has another, weekday job, in a hospital research facility. I've been working with him for nearly two years now, but the first year and a half were when I was (more or less) still "normal," not counting the few months preceding the knee surgery. Thanks for your input.

 

[FraidyCat]

Just ignore anyone who tells you that you won't get better without pushing yourself hard. Some challenge is good but you are not in training, you're in recovery and it's counter productive to push yourself to the point of pain or exhaustion. Don't be afraid to say "enough" and stop for the day.

I hope I have the emotional fortitude to tell the new PT, who conveyed exactly the message that I'd need to push myself when I first saw her for evaluation last week, that I'm not willing to exceed certain limits. I'm afraid she might then "show me the door" and I'd be left with no PT. The PT who I'd been seeing for the last several months was at the opposite end of the spectrum--she was doing nearly nothing with me--there was a lot of mild knee massaging and exercises involving slight bending. It's very hard to schedule with PTs in my city; they're all overbooked and sometimes the wait to get started with someone is weeks. This recovery, and the prospect of perhaps needing to have the same surgery on the opposite knee in near future, are taxing my coping mechanisms to the hilt.

 

[Jockette]

Your thread is this overall recovery “journal” here that you are writing in.

Your posts are the individual sections that you write, like I’m writing in right now.

Think of it like a book. The whole book in general is your “thread.” The pages are like your “posts.”

Read through This link about finding your thread again and see if it makes more sense.

 

[EalingGran]

It's very hard to schedule with PTs in my city; they're all overbooked and sometimes the wait to get started with someone is weeks. This recovery

Are there any good pilates teachers?
I never had any formal physio/PT after I left hospital. I had private pilates lessons with my excellent pilates teacher. Her philosophy ( and I think it is a more general pilates philosophy) is never to push to pain. I now have 150 degree flexion- just a few degrees less than my unoperated leg and my muscles are at least as strong as they were pre-op if not stronger. She works with my body not against it and is interested in exploring causes if I have any aches or pains in my joints.

 

[EalingGran]

My teacher also has loads of free classes on YouTube ( Google Katja pilates).
There is a side lying one for glute strengthening with no squats which is good for knee recovery. But I would probably try to get some individual teaching as well.

 

[Layla]

Hi Fraidycat,
You may consider initiating a conversation with your PT expressing that you're looking forward to working with them as you recover and while you want to challenge yourself, you also want to be mindful of your limits. You won't push through pain, and you'd appreciate direction that respects that while still helping you progress through recovery. Ask if the PT feels you can work together to find the right balance? If they're not agreeable, you may want to go to Plan B.

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Happy Monday, I hope its the beginning of a good week!
@FraidyCat

 

[benne68]

I'm afraid she might then "show me the door" and I'd be left with no PT.

Honestly, NO PT is better than BAD PT -- but I doubt that she "fire" you because it is not in her best interest to lose you. Remember she works for YOU, not the other way around. Trust yourself, because only you know what your body is feeling.

We are here for you!

 

[benne68]

Been thinking about you, @FraidyCat? It's been a couple of weeks since your fall and I hope you have recovered.

Give us an update on how you are doing when you have a moment.

 

[FraidyCat]

Been thinking about you, @FraidyCat? It's been a couple of weeks since your fall and I hope you have recovered.

Give us an update on how you are doing when you have a moment.

Thanks for your kind thoughts, @benne68. I don't seem to have sustained any lingering injury from the fall. I've been back at the gym several times since but have so far declined to do the step exercise again, though my PT (who I see at another facility) thinks they are important. The fall occurred when I was stepping backwards off of the platform. I can't imagine doing that again, as I'd need 100% trust that the PT or trainer standing behind me could catch me if I were to trip again and start to fall, and I don't feel that confidence.

 

[mendogal]

I'm really relieved to read the fall soft tissue aggravation is over!

(sighing - about PTs) Many of us have had excellent recoveries without the step up exercises.

 

[FraidyCat]

I'm really relieved to read the fall soft tissue aggravation is over!

(sighing - about PTs) Many of us have had excellent recoveries without the step up exercises.

Thanks! My dilemma is that, though I'm now seven months postop, I don't think my recovery has been especially satisfactory so far--I still can't navigate stairs normally, and my walking gait and pace leave a lot to be desired. Plus my ROM seems stuck at 105--though my PT before the current one said that 105 would suffice for most activities of daily life. So I feel susceptible to believing when a PT or trainer tells me that this, that, or the other is crucial to recovery.

I've now been in PT for seven months (!). I feel like I'm wavering between just stopping PT altogether and resuming my trainer-led gym exercises three times a week vs the two that I can fit in now, what with the PT occupying a third day. The PT facility has a recumbent bike and a foot-press machine, which my gym lacks. The surgeon--during my rushed, unsatisfying appointment with him a month ago--seemed to think that a bike was of great importance. I can't ride a regular stationery bike, only a recumbent bike. Any thoughts on the essentiality (or lack thereof) of bike exercise would be welcome.

 

[EalingGran]

Any thoughts on the essentiality (or lack thereof) of bike exercise would be welcome.

I never did any bike exercises or formal PT- just regular pilates and my ROM is excellent.

 

[Alice Nutter]

I'm really relieved to read the fall soft tissue aggravation is over!

(sighing - about PTs) Many of us have had excellent recoveries without the step up exercises.

Thanks! My dilemma is that, though I'm now seven months postop, I don't think my recovery has been especially satisfactory so far--I still can't navigate stairs normally, and my walking gait and pace leave a lot to be desired. Plus my ROM seems stuck at 105--though my PT before the current one said that 105 would suffice for most activities of daily life. So I feel susceptible to believing when a PT or trainer tells me that this, that, or the other is crucial to recovery.

I've now been in PT for seven months (!). I feel like I'm wavering between just stopping PT altogether and resuming my trainer-led gym exercises three times a week vs the two that I can fit in now, what with the PT occupying a third day. The PT facility has a recumbent bike and a foot-press machine, which my gym lacks. The surgeon--during my rushed, unsatisfying appointment with him a month ago--seemed to think that a bike was of great importance. I can't ride a regular stationery bike, only a recumbent bike. Any thoughts on the essentiality (or lack thereof) of bike exercise would be welcome.

I bought a bike on FB Marketplace for $35. It's an upright, because that was what I was looking for, but I'm pretty sure there were recumbent bikes too. It's very basic, and it's all I need. It's a gamechanger having it in your house.

 

[mendogal]

The bike is simply a tool you can opt to add to your toolkit.
To increase ROM, you would want to set both the seat and youself in such a way that it's actually your knees, not your hips, that are doing most of the flexing. May take some trial and error to find the right seat/pedal distance.

Are you doing seated heel slides? I always recommend doing them VERY slowly, in time with slow deep breathing and maximum possible relaxation (You might warm up the quads with a short walk first as you want them to really relax into a slow stretch with the heel slide).

Do a few within your current comfort zone. Then go just into the gray area of discomfort, not pain, continuing slow deep breathing and relaxing into it for 5 seconds. Only do four or five reps into discomfort.

Doing it this low stress way you could easily do it three x day.